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Heartrate variability biofeedback for migraine using a smartphone application and sensor: A randomized controlled

Mia T Minen1, Sarah Corner2, Thomas Berk2

  • 1Department of Neurology, NYU Langone Health, 550 1st Avenue, New York, NY 10016, USA; Department of Population Health, NYU Langone Health, 550 1st Avenue, New York, NY 10016, USA.

General Hospital Psychiatry
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PubMed
Summary

Heart rate variability (HRV) biofeedback via app was feasible for migraine prevention. While overall results were not significant, high engagement with HRV biofeedback showed potential benefits for migraine quality of life.

Keywords:
Behavioral therapyBiofeedbackHeartrate variabilityMigraineSmartphonemHealth

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Area of Science:

  • Neurology
  • Biofeedback Technology
  • Migraine Research

Background:

  • Existing biofeedback methods like hand temperature and electromyography show promise for migraine prevention.
  • Heart rate variability (HRV) biofeedback has not been previously studied for its efficacy in managing migraines.

Purpose of the Study:

  • To evaluate the feasibility and acceptability of an app-based HRV biofeedback intervention for individuals experiencing migraines.
  • To assess the clinical effectiveness of HRV biofeedback on migraine-specific quality of life.

Main Methods:

  • A 2-arm randomized trial compared an 8-week app-based HRV biofeedback program (HeartMath) against a waitlist control group.
  • Feasibility and acceptability were measured by session completion rates, duration, user satisfaction, and reported barriers.
  • The primary clinical outcome was assessed using the Migraine-Specific Quality of Life Questionnaire (MSQv2).

Main Results:

  • Participants in the HeartMath group completed an average of 29 sessions, with 9/29 reporting technology-related barriers.
  • No statistically significant difference in MSQv2 scores was observed between the HRV biofeedback group and the waitlist control group.
  • However, participants with high engagement (high users) in the HRV biofeedback app reported a significant reduction in MSQv2 scores at day 30 (p=0.010).

Conclusions:

  • App-based HRV biofeedback is a feasible and acceptable intervention for individuals with migraines when used on a time-limited basis.
  • While overall clinical outcomes did not show significant improvement, high levels of user engagement with HRV biofeedback suggest potential benefits for migraine management.